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Subtle to severe hepatobiliary morbidity in Opisthorchis viverrini endemic settings in Southern Laos.
[cholangiocarcinoma]
Evidence
of
severe
hepatobiliary
morbidity
associated
with
Opisthorchis
viverrini
liver
fluke
infection
including
cholangiocarcinoma
(
CCA
)
is
scarce
in
Laos
although
O
.
viverrini
infection
is
highly
prevalent
.
We
assessed
hepatobiliary
morbidity
using
abdominal
ultrasonography
(
US
)
in
O
.
viverrini
adult
patients
in
Saravan
province
,
Southern
Laos
.
A
random
sample
of
431
O
.
viverrini
patients
from
10
villages
underwent
abdominal
US
.
Mild
,
moderate
and
markedly
advanced
periductal
fibrosis
was
diagnosed
in
7
.
0
%
,
66
.
5
%
,
and
17
.
0
%
of
patients
,
respectively
.
Normal
liver
parenchyma
was
seen
in
only
9
.
5
%
of
patients
.
Presence
of
gall
stones
(
13
.
2
%
)
,
sludge
(
1
.
4
%
)
,
gall
wall
thickening
(
1
.
2
%
)
,
bile
duct
dilatation
(
1
.
6
%
)
,
fatty
liver
(
12
.
0
%
)
,
kidney
stones
(
8
.
6
%
)
and
cysts
(
7
.
9
%
)
were
diagnosed
in
considerable
frequencies
.
In
five
patients
(
1
.
2
%
)
hepatobiliary
lesions
suggesting
CCA
were
diagnosed
.
Tumour
markers
,
i
.
e
.
Interleukin-
6
,
plasminogen
activator
inhibitor
and
carbohydrate
antigen
19
-
9
were
within
normal
range
.
The
number
of
CCA
suspected
liver
masses
and
hepatobiliary
morbidity
diagnosed
among
clinically
asymptomatic
adult
patients
in
O
.
viverrini
endemic
area
presents
a
major
public
health
concern
in
Laos
.
However
,
definitive
diagnosis
of
Opisthorchis-related
severe
sequelae
including
CCA
is
urgently
needed
to
gauge
the
burden
of
this
deadly
disease
in
Laos
.
Diseases
Validation
Diseases presenting
"severe sequelae"
symptom
cholangiocarcinoma
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